Vertical mattress suture

The vertical mattress suture is another strong technique used to improve wound edge eversion and closure under tension. It is placed in two levels: a deep bite that provides strength and a more superficial bite that helps align the skin edges precisely. This makes it especially useful when the wound edges tend to invert or when stronger approximation is required.

The major advantage of this stitch is that it provides both deep support and superficial precision. It is particularly helpful in wounds where exact edge alignment is important. However, it must be placed carefully, because overly tight or poorly placed vertical mattress sutures can compromise skin circulation or create prominent marks.

Students should learn that this stitch requires careful depth control and symmetry. The deeper and more superficial components must work together to provide both strength and cosmetic alignment.